Clinical Edge

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PCSK9 Inhibitors and LDL-C Reduction

J Endocrinol Invest; ePub 2019 Feb 14; Dicembrini, et al

Proprotein convertase subtilisin/kexin (PCSK9) inhibitors are effective in reducing low-density lipoprotein cholesterol (LDL-C) and the incidence of major cardiovascular events in high-risk patients, according to a recent review and meta-analysis. All randomized trials (>12 weeks) until December 1, 2017 comparing PCSK9 inhibitors with placebo or active drugs were included. The primary endpoints were 1) LDL-C at endpoint; 2) major CV events (MACE); and 3) all-cause mortality. 38 trials were identified, with mean duration of 36.4 weeks. Researchers found:

  • The reduction of LDL-C at endpoint vs placebo, ezetimibe, and high-dose statins was ‒65.3%, ‒57.7%, and ‒34.5%, respectively.
  • Treatment with PCSK9 inhibitors was associated with a reduction in the incidence of MACE.
  • All-cause mortality and CV mortality were not reduced by treatment with PCSK9 inhibitors.

Citation:

Dicembrini I, Giannini S, Ragghianti B, Mannucci E, Monami M. Effects of PCSK9 inhibitors on LDL cholesterol, cardiovascular morbidity and all-cause mortality: A systematic review and meta-analysis of randomized controlled trials. [Published online ahead of print February 14, 2019]. J Endocrinol Invest. doi:10.1007/s40618-019-01019-4.